The associations between daily spring pollen counts, over-the-counter allergy medication sales, and asthma syndrome emergency department visits in New York City, 2002-2012.

BACKGROUND: Many types of tree pollen trigger seasonal allergic illness, but their population-level impacts on allergy and asthma morbidity are not well established, likely due to the paucity of long records of daily pollen data that allow analysis of multi-day effects. Our objective in this study was therefore to determine the impacts of individual spring tree pollen types on over-the-counter allergy medication sales and asthma emergency department (ED) visits. METHODS: Nine clinically-relevant spring tree pollen genera (elm, poplar, maple, birch, beech, ash, sycamore/London planetree, oak, and hickory) measured in Armonk, NY, were analyzed for their associations with over-the-counter allergy medication sales and daily asthma syndrome ED visits from patients' chief complaints or diagnosis codes in New York City during March 1st through June 10th, 2002-2012. Multi-day impacts of pollen on the outcomes (0-3 days and 0-7 days for the medication sales and ED visits, respectively) were estimated using a distributed lag Poisson time-series model adjusting for temporal trends, day-of-week, weather, and air pollution. For asthma syndrome ED visits, age groups were also analyzed. Year-to-year variation in the average peak dates and the 10th-to-90th percentile duration between pollen and the outcomes were also examined with Spearman's rank correlation. RESULTS: Mid-spring pollen types (maple, birch, beech, ash, oak, and sycamore/London planetree) showed the strongest significant associations with both outcomes, with cumulative rate ratios up to 2.0 per 0-to-98th percentile pollen increase (e.g., 1.9 [95% CI: 1.7, 2.1] and 1.7 [95% CI: 1.5, 1.9] for the medication sales and ED visits, respectively, for ash). Lagged associations were longer for asthma syndrome ED visits than for the medication sales. Associations were strongest in children (ages 5-17; e.g., a cumulative rate ratio of 2.6 [95% CI: 2.1, 3.1] per 0-to-98th percentile increase in ash). The average peak dates and durations of some of these mid-spring pollen types were also associated with those of the outcomes. CONCLUSIONS: Tree pollen peaking in mid-spring exhibit substantive impacts on allergy, and asthma exacerbations, particularly in children. Given the narrow time window of these pollen peak occurrences, public health and clinical approaches to anticipate and reduce allergy/asthma exacerbation should be developed.

Levels and determinants of tree pollen in New York City.

Exposure to allergenic tree pollen is a risk factor for multiple allergic disease outcomes. Little is known about how tree pollen levels vary within cities and whether such variation affects the development or exacerbation of allergic disease. Accordingly, we collected integrated pollen samples at uniform height at 45 sites across New York City during the 2013 pollen season. We used these monitoring results in combination with adjacent land use data to develop a land use regression model for tree pollen. We evaluated four types of land use variables for inclusion in the model: tree canopy, distributed building height (a measure of building volume density), elevation, and distance to water. When included alone in the model, percent tree canopy cover within a 0.5 km radial buffer explained 39% of the variance in tree pollen (1.9% increase in tree pollen per one-percentage point increase in tree canopy cover, P<0.0001). The inclusion of additional variables did not improve model fit. We conclude that intra-urban variation in tree canopy is an important driver of tree pollen exposure. Land use regression models can be used to incorporate spatial variation in tree pollen exposure in studies of allergic disease outcomes.

The association of tree pollen concentration peaks and allergy medication sales in new york city: 2003-2008.

The impact of pollen exposure on population allergic illness is poorly characterized. We explore the association of tree pollen and over-the-counter daily allergy medication sales in the New York City metropolitan area. Dates of peak tree pollen (maple, oak, and birch) concentrations were identified from 2003 to 2008. Daily allergy medication sales reported to the city health department were analyzed as a function of the same-day and lagged tree pollen peak indicators, adjusting for season, year, temperature, and day of week. Significant associations were found between tree pollen peaks and allergy medication sales, with the strongest association at 2-day lag (excess sales of 28.7% (95% CI: 17.4-41.2) over the average sales during the study period). The cumulative effect over the 7-day period on and after the tree pollen peak dates was estimated to be 141.1% (95% CI: 79.4-224.1). In conclusion, tree pollen concentration peaks were followed by large increases in over-the-counter allergy medication sales.

Pleistocene megafaunal collapse, novel plant communities, and enhanced fire regimes in North America.

Although the North American megafaunal extinctions and the formation of novel plant communities are well-known features of the last deglaciation, the causal relationships between these phenomena are unclear. Using the dung fungus Sporormiella and other paleoecological proxies from Appleman Lake, Indiana, and several New York sites, we established that the megafaunal decline closely preceded enhanced fire regimes and the development of plant communities that have no modern analogs. The loss of keystone megaherbivores may thus have altered ecosystem structure and function by the release of palatable hardwoods from herbivory pressure and by fuel accumulation. Megafaunal populations collapsed from 14,800 to 13,700 years ago, well before the final extinctions and during the Bølling-Allerød warm period. Human impacts remain plausible, but the decline predates Younger Dryas cooling and the extraterrestrial impact event proposed to have occurred 12,900 years ago.

Sporormiella and the late Holocene extinctions in Madagascar.

Fossil spores of the dung fungus Sporormiella spp. in sediment cores from throughout Madagascar provide new information concerning megafaunal extinction and the introduction of livestock. Sporormiella percentages are very high in prehuman southwest Madagascar, but at the site with best stratigraphic resolution the spore declines sharply by approximately 1,720 yr B.P. (radiocarbon years ago). Within a few centuries there is a concomitant rise in microscopic charcoal that probably represents human transformation of the local environment. Reduced megaherbivore biomass in wooded savannas may have resulted in increased plant biomass and more severe fires. Some now-extinct taxa persisted locally for a millennium or more after the inferred megafaunal decline. Sites in closed humid forests of northwest Madagascar and a montane ericoid formation of the central highlands show only low to moderate Sporormiella percentages before humans. A subsequent rise in spore concentrations, thought to be evidence for livestock proliferation, occurs earliest at Amparihibe in the northwest at approximately 1,130 yr B.P.